We’ve worked with thousands of scientists and doctors at the Center for Communicating Science, and I’ve seen many times over that listening begins before you even start trying to communicate. You picture an audience and think, What are they already aware of? Where should I start? How deep should I go? What are they actually eager to know? If I start too far in, will I be using concepts they don’t’ really understand?

Once, I came home from a visit to Cern in Switzerland where scientists had just found the Higgs boson. All the newspapers were filled with stories of the discovery, and I was at dinner with a friend who was eager to hear what I knew about it. “What’s the Higgs boson?” she asked. I gave it a try, even though I’m better at asking questions about complicated things than I am at answering them.

You not only have to start with what they already understand, you have to know when to stop, or they’ll feel swamped. If I had gone on into my sketchy understanding of how the Higgs particle is crucial to the Standard Model of physics, I’d not only have been in over my own head, I’d have been in over hers. She might have felt that crushing sense of hopelessness that tells you it’s all too much, and she might never ask a question like that again.

You not only have to start with what they already understand, you have to know when to stop, or they’ll feel swamped.

I started again, earlier in the story, and muddled my way through a description of particles as the basic building blocks of matter, but I could see she still found it a little vague. Later, I asked Brian Greene, the physicist, how he would explain the notion of a particle. His description was homey. I wish I’d had it the night I’d come back from Cern. (“If you cut a loaf of bread in half, and then take one of the halves and cut that in half, and keep doing that, eventually you’ll get down to the smallest bit possible. That’s a particle.”)

If I Understood You, Would I Have This Look on My Face?

So, knowing what they’re ready to hear is critical, and coming in too early or too late can be confusing. And, of course, having a clear, homey image like Brian’s helps the listener visualize it and remember it.

Sometimes, though, they don’t want an explanation at all.

If someone has a medical problem, do they want a detailed account of the facts (some do), or are they too vulnerable for that? Are they even able to hear the facts at that moment? Maybe they need presence more than knowledge.

Valeri Lantz-Gefroh, the director for improvisation at the Alda Center at Stony Brook, tells a story about this. Val is an accomplished actress with extraordinary teaching skills. I’ve watched her teaching workshops around the country. She’s clearheaded and runs her improv classes with a kind but firm hand. She doesn’t strike me as overly sentimental, but when she told me about an encounter between a doctor and a patient, she choked up.

“One of our medical students came and met me after one of our classes,” she said. “It was a late class and he stayed until 8 o’clock at night just to tell me how important improv has been to him. And the exercise that really stuck with him is the mirror exercise. He told me about a woman he had met a month earlier. She was dying. They had just found out that she had metastatic lung cancer. She had about two weeks to live. This student was on the rounds with the internist and he listened as the internist shared the news with her. But he told her in such a way that, the student felt, she really didn’t get it. She didn’t seem to understand what was going on. The student said. ‘I’d like to talk to her. Would that be all right?’ The internist gave him permission and left.

“The student sat next to her and held her hand. He explained to her slowly and simply what was going on. He didn’t use the word metastatic. He didn’t use the word malignancy. Even those words felt like too much for her. And for the first time the woman cried. The student told me that…”

Valerie paused here for a moment and said, “…I’m going to cry, just talking about it.” After a moment, Val went on. “The med student said, ‘I cried too…’ And then – for the first time – the woman began asking questions. And he was able to answer them. He said, ‘It was the perfect mirror exercise. I had been leading, but then she took over and I followed. And, ultimately, what emerged was that I helped her understand death — and she helped me understand how to be a better doctor. It was exactly what the mirror exercise is about — that level of connection and active listening.’”

Our goal is not to make doctors cry, or to be overcome by the patient’s emotion. We certainly don’t want them to get trapped in “Affective Quicksand.” In this case, though, he was reacting to a sudden ability to connect so richly with another person. He was moved by his own personal breakthrough.

Even though he had a strong emotional reaction to his patient, he was engaged in a subtle exercise of leading her from one state of thinking to another — something that can happen in radically different situations.

Meet the Writer

Alan Alda is an actor, director, screenwriter and an advisor and board member for the World Science Festival. He is also a founding member of the Alan Alda Center for Communicating Science at Stony Brook University in Stony Brook, New York.